Epileptic encephalopathy with electrical status epilepticus during slow sleep: Evaluation of treatment response from a tertiary center

Background. This study aimed to evaluate the clinical, electrophysiological, etiological features, and treatment response in children with epileptic encephalopathy with electrical status epilepticus during slow sleep (ESES). Methods. Clinical data, records of electroencephalograms (EEG), and brain magnetic resonance imaging (MRI) findings of 33 patients with ESES who were treated, and followed up for at least one year were retrospectively analyzed. Results. Of all patients, 57.6% were male, and 42.4% were female. The mean age was 10.45 +/- 2.88 years. At first admission, 90% of patients had seizures, and 10% had only school failure. Twelve patients had childhood focal epileptic syndrome. In etiology, asphyxia (n=6), hydrocephalus (n=2), polymicrogyria (n=1), and mesial temporal sclerosis (n=1) were determined. Neurological examination was abnormal in 27.2%, and brain MRI findings were pathological in 36.3% of the patients. During the ESES phase, the spike-wave index (SWI) on the non-rapid eye movement (NREM) sleep EEG was >85% in 16 patients and 50-85% in 17 patients. Only one patient received one, and the others had at least two antiseizure medications. Benzodiazepines were found to be the most effective treatment. In the two-year follow-up, 24 patients (72.7%) were seizure-free, and nineteen patients (57.5%) had complete recovery of SWI on their NREM sleep EEG. There was a significant correlation with reduction of the SWI on the EEG and seizure control (p <0.001). In addition, a significant correlation was found between neurocognitive and behavioral scores scored before and after treatment, seizure control, and EEG recovery. Conclusions. ESES is an epileptic encephalopathy that can be treated safely with antiseizure medications. Neurocognitive examinations and follow-up of EEG findings are valuable in terms of the treatment response. Benzodiazepines were found to be very effective in additional treatment

Vitamin D Status in Turkish Children During the Covid-19 Pandemic; A Single Center Experience

Objective: COVID-19-related lockdown decreased the children's exposure to sunlight, and they were susceptible to 25-hydroxyvitamin D [25(OH)D] deficiency. The present study aimed to examine the 25(OH)D levels 2 years before and during the first year of the pandemic. Materials and Methods: This study included children who underwent health checks between the equivalent period during 2018 October–2020 March, and they were categorized according to the date vitamin D was checked; 2018 October -2019 March (Group 1), 2019 October and 2020 March (Group 2), 2020 October, and 2021 March (Group 3). We compared the children’s 25(OH)D levels and vitamin D deficiency rates between Groups 1, 2, and 3. Results: We found that the mean of the children's 25(OH)D levels was lower during COVID-19 than in the last two years before the pandemic (p=0.039). The present study showed that the rates of 25(OH)D deficiencies among ages 0-1, and 4-7 were higher during the pandemic than before (p= 0.013, p=0.011). Conclusion: Reduced sunbathing time during confinement is associated with lower 25(OH)D levels among children aged 4–7. Although increased rates of 25(OH)D deficiency in infants are worrying

A rare cause of globus pallidus and dentate nucleus hyperintensity in childhood: MBOAT mutation

Mutations in mammalian membrane-bound O-acyltransferase domain-containing (MBOAT) 7 gene are a rare cause for intellectual disability, developmental delay, autistic findings, epilepsy, truncal hypotonia with appendicular hypertonia, and below-average head sizes. Pathogenic variants in MBOAT7 gene show these nonspecific clinical features that are seen in many other neurometabolic diseases. Therefore, specific neuroimaging findings can be valuable key factors for differential diagnosis. Magnetic resonance imaging (MRI) findings of T2 hyperintensity in bilateral globus pallidi and dentate nuclei are seen in a few neurometabolic diseases with similar clinical features of developmental delay and hypotonia, as in our cases. While evaluating the patients with similar phenotypes and specific MRI findings, MBOAT7 deficiency should be kept in mind. Here, we identified two brothers who had a novel homozygous variant in MBOAT7 gene and aimed to raise awareness about this newly described disease

The impact of COVID-19 pandemic and quarantine process a center in Turkey on anxiety levels of pediatric patients with epilepsy

Introduction: In this study, we aimed to compare the levels of state and trait anxiety in pediatric patients with epilepsy and healthy controls during the COVID-19 outbreak in Turkey. Materials and Methods: In this study, the state (STAI-I) and trait (STAI-II) anxiety scales were applied to patients between the ages of 10-17 years that had been followed due to epilepsy and were in quarantine. Anxiety status and potential risk factors were compared with healthy age and gender-matched control group. Results: This study included 40 epilepsy patients and 40 controls. Among the patients in the epilepsy group 92.5% had moderate and 7.5% had severe anxiety (mean value of STAI-I and STAI-II were 40.3±4.8 and 40.9±10.5, respectively). There was no significant difference between epilepsy and controls groups in terms of mean STAI-I and STAI-II scale scores (p=0.756, 0.914). When the state anxiety scores were categorized as low, moderate, and high anxiety levels, moderate-to-high state anxiety was detected in the epilepsy group, and moderate-to-low state anxiety in the control group. The state anxiety level was found to be high in patients with high seizure frequency (p=0.045). No significant relationship was found between state and trait anxiety scale scores and factors such as epilepsy duration, quarantine duration, seizure type, drug resistance, and type of antiepileptics. Conclusion: In situations that commonly affect community health, clinicians should focus also on the mental health of epileptic patients. Therefore, we believe that mental health support should be provided to pediatric patients with epilepsy

Algılanan marka otantikliği ölçeğinin Türkçe geçerlemesi

Son yıllarda artan rekabet koşullarının etkisi ile birlikte, marka otantikliği hem pazarlama araştırmacıları hem de uygulamacıları arasında önemli bir yer teşkil eden bir kavram olarak gösterilmektedir. Buna bağlı olarak, tüketicilerin markalarla olan bağları ve marka otantikliğini nasıl algıladıkları konularına verilen önem giderek artmasına rağmen, Türkiye bağlamında marka otantikliği üzerine yapılan ampirik çalışmaların sayısı oldukça kısıtlıdır. Marka otantikliğinin kültüre özgü bir kavram olmasına ve farklı düzeydeki kültürel sermayelere sahip tüketicilerin bir markayı otantik olarak yorumlamasında farklı işaretler ya da özelliklere dayandıkları önerisine dayalı olarak, bu çalışmanın amacı Morhart vd. (2015) tarafından geliştirilen algılanan marka otantikliği ölçeğinin Türkçe versiyonunun geçerliliğinin test edilmesidir. Ölçek geçerleme araştırması kapsamında, 407 katılımcının oluşturduğu örneklem üzerinden elde edilen veriler ile algılanan marka otantikliği ölçeği için Doğrulayıcı Faktör Analizi yapılmıştır. Çalışmanın bulguları Morhart vd. (2015) tarafından geliştirilen orijinal dört faktörlü - süreklilik, güvenilirlik, bütünlük ve sembolizm - algılanan marka otantikliği ölçeğinin geçerlenerek, Türkçeye uygunluğunu ortaya koymaktadır.Publisher's Versio

Clinical, genetic, and outcome characteristics of pediatric patients with primary hemophagocytic lymphohistiocytosis

Objectİive: In this study, we sought to describe the clinical, laboratory, and genetic characteristics of patients diagnosed with primary hemophagocytic lymphohistiocytosis. Thus, we aimed to evaluate the early diagnosis and appropriate treatment options for pediatric hemophagocytic lymphohistiocytosis patients. Materials and Methods: Medical records of 9 patients diagnosed with primary hemophagocytic lymphohistiocytosis between November 2013 and December 2019 were analyzed retrospectively. Clinical, genetic, and laboratory characteristics, family histories, initial complaints, physical examination findings, age at diagnosis, treatment choices, and clinical follow-up of all patients were investigated. Results: The mean age at diagnosis was 11 months (range: 1.5 months to 17 years). Genetic analysis was performed in all patients, and a disease-related mutation was detected in 8 (89%) of them. Among clinical features, 6 (66%) patients had fever, 5 (56%) had splenomegaly, 4 (44%) had lymphadenopathy, 4 (44%) had skin rash, and 4 (44%) had neurological findings. Hemophagocytosis was observed in the bone marrow samples of 6 (66%) patients. Disease remission was achieved in 7 (78%) patients. Hematopoietic stem cell transplantation was performed in 7 (78%) patients. Conclusion: Hemophagocytic lymphohistiocytosis may present with different clinical symptoms that can cause a significant diagnostic delay. The only curative treatment option in primary hemophagocytic lymphohistiocytosis patients is hematopoietic stem cell transplantation. The chemotherapy should be started as early as possible, in order to achieve a disease remission. Patients should be referred to the appropriate bone marrow transplant center for hematopoietic stem cell transplantation as soon as they reach the disease remission

Characteristics of food allergy in children: National multicenter study

Conference: Congress of the European-Academy-of-Allergy-and-Clinical-Immunology (EAACI) Location: Lisbon, PORTUGAL Date: JUN 01-05, 2019Background : Food allergies impose a significant burden on the life of the child and the family. In this study, to determine the demographic characteristics of food allergies, we investigated the characteristics of patients with food allergies in different regions of Pediatric Allergy- Immunology departments in Turkey. Method : Turkey ' s National Study of Allergy and Clinical Immunology Society has conducted a Study Group on Food Allergies. 25 centers participated in this multicenter, cross- sectional and descriptive study.European Academy of Allergy and Clinical Immunolog

A study on primary education seventh grade students icon narrative texts

Yüksek Lisans Tezi. YÖK Tez Merkezi No: 321282Bu araştırma, ilköğretim 7. sınıf öğrencilerinin öyküleyici metin yazma beceri düzeyini tespit etmek amacıyla yapılmıştır. Araştırma betimsel bir çalışmadır ve araştırmada ilişkisel tarama modeli kullanılmıştır. Araştırmanın çalışma evrenini Amasya ili Merzifon ilçesinde 2011-2012 eğitim öğretim yılında öğrenim gören yedinci sınıf öğrencileri oluşturmaktadır. Örneklemi ise Amasya ili Merzifon ilçesi ilköğretim okullarından sosyo-ekonomik düzeyi düşük, orta ve yüksek olan 5 ilköğretim okulunda öğrenim gören 150 yedinci sınıf öğrencisi oluşturmaktadır. Öğrencilerin öyküleyici metin yazma beceri düzeylerini belirlemek için öğrencilere öyküleyici metin yazdırılmış, öğrencilerin metinleri yazılı anlatımı değerlendirme formu ve hikâye elementleri değerlendirme ölçeğine göre değerlendirilmiştir. Araştırma sonucunda öğrencilerin öyküleyici metin yazma becerisine istenen düzeyde ulaşamadıkları tespit edilmiştir. Öğrencilerin yazılı anlatım becerilerinin cinsiyet, anne ve babanın eğitim düzeyi, ailenin sosyo-ekonomik düzeyi eve süreli yayın alınması ve okul öncesi eğitim alma durumuna göre anlamlı farklar bulunduğu belirlenmiştir.This research was studied to identify the ability level of the 7 th class students? writing narrative text. The research is a representing study and relational surveillance model was used. İn Amasya city Merzifon town seventh class students who is studying in 2011-2012 educational year form the studying ground of this research. 150 seventh class students who study in 5 different schools which belong low, medium and high socio- economical status form the sample. To identify the ability level of students? writing narrative text, narrative text is written to the students, these texts are evaluated according to narration elements evaluation scale and writing explanation evaluation scale. According to the research, it was determined that they couldn?t arrive the desirable ability level of writing narrative text. İt was agreed that students? writing explanation ability changes according to gender, their mother and father?s educational level, their families?s socio-economic statu, buying periodical and pre-school education

Paradoxic relations between basilar artery reconfiguration and superior cervical ganglia ischemia after bilateral common carotid artery ligation

Background: The relationship between superior cervical ganglia (SCG) ischemia due to bilateral common carotid artery ligation (BCCAL) and basilar artery (BA) reconfiguration was investigated. Methods: Twenty-three rabbits were randomly divided into 3 groups: group III rabbits underwent BCCAL (n = 13), group II rabbits were sham-operated controls (n = 5), and group I rabbits did not undergo surgery (n = 5). Degenerated neuron densities (DND) within the SCG were correlated with the BA vasodilatation index (VDI). Results: Mean live and DND in SCG of group I rabbits were 11.235 ± 982/μm3 and 11 ± 3/μm3, respectively, with a mean heart rate of 294 ± 21 beats/min. Mean SCG DND and heart rates were 213 ± 42/μm3 and 242 ± 17 beats/min for the sham group (group II) rabbits and 1743 ± 285/μm3 and 199 ± 19 beats/min for the study group (group III) rabbits, respectively. The BA VDI values in the sham group (group II) (1.32 ± 0.10) and the study group (group III) (0.976 ± 0.112) significantly differed from those in the control group (group I) (1.65 ± 0.12; P < 0.005) versus the sham group (group II) (P < 0.0001) versus the BCCAL applied group (group III) and between group II and group III (P < 0.005). Conclusions: A meaningful and paradoxic correlation was detected between the BA VDI values and degenerated neuron density of SCG after BCCAL. Although a low degenerated neuron density within SCG may provoke excessive sympathetic activity and prevent excessive BA dilatation with steno-occlusive carotid artery diseases, a high degenerated neuron density may cause dangerous vasodilatation of BA

Yeni medyada hikayeleştirme kullanımı bağlamında marka sadakati

Ürün çeşitliliğinin gün geçtikçe daha da arttığı bugünün pazarında rekabet, markalar açısından oldukça zor hale gelmiştir. Bu durum, markaları diğerlerinin arasından sıyrılabilmeleri için yeni medya ortamlarında var olma ihtiyacını doğurmuştur. Markaların yeni medyadaki varlıkları, oluşturdukları içeriklerle mümkündür. Bu noktada markalar için etkili içerik oluşturma yöntemlerinden hikayeleştirme kullanımı oldukça önem kazanmaktadır. İnsanların birbirleriyle iletişim kurma yolunun hikayeler vasıtasıyla gerçekleştirmesi; markaları da tüketicilerle iletişiminde hikaye anlatımına başvurması gerekliliğini kuvvetlendirmektedir. Bu araştırmada markaların yeni medyadaki hikayeleştirme kullanımları ile tüketicilerde oluşması amaçlanan marka sadakati ilişkisi ve bu ilişkideki marka-benlik ilişkisinin rolü irdelenmiştir. Araştırma kapsamında, anket katılımcılarının demografik özelliklerinden yaş, cinsiyet, eğitim düzeyi, aktif iş hayatı durumu ve medeni hal dikkate alınarak; marka sadakati ve marka-benlik ilişkisi bağlamında farklılık yaratıp yaratmadığı da incelenmiştir. Araştırmanın sonucunda; markaların dijital hikayeleştirme kullanımları etkisinin tüketiciler için önemli olduğu, marka sadakati oluşumunda etkili olduğu ve bunun yanı sıra marka-benlik ilişkisinin de söz konusu oluşumda kısmi aracı rol oynadığı saptanmıştır.--------------------Considering increasing product variety, in today’s highly rigid market conditions, competition becomes tremendously tough for brands. As a result of these conditions, in order to differentiate themselves, brands inevitably look for ways to take place in new media. And when it comes to new meadia, content emerges as the backbone of any brand. Since storytelling has been a magical method in interpersonal communication, brands also apply to storytelling in order to get into communication with their customers. Digital storytelling, as the form of storytelling existing in new media, seems to appear as an efficient content formation method. In this study, brands’ digital storytelling usage and its effect to the brand loyalty is examined. Within this context, digital storytelling usage effect to self-brand connection is also elaborated. In this research, some demographic properties of participants such as age, gender, education level, working status, and marital status are elaborated in terms of their possible impacts to the brand loyalty and self-brand connection. As a result, it is seen that the impact of digital storytelling plays an important role for consumers. It is also effective over the formation of the brand loyalty and self-brand connection comes out as a partial moderator in this formation